“All my independence has gone ....this place has taken it away...I’ve no quality of life now, and feel like I’m not even a human being anymore.”

So spoke Lawrence, a young adult with a Spinal Cord Injury who was interviewed by researchers from Loughborough University about his life in a nursing home.  During the same interview, Lawrence explained that he was “depressed, weeping away” and admitted he had considered what he described as “taking the coward’s way out.”

Sadly, experiences such as Lawrence’s could be about to become more common.  Our previous blog piece highlighted the possibility that the recent closure of the Independent Living Fund may force many disabled people to move from their own homes into residential care. 

However, there are other cuts to funding which could also lead to this result.  This week, for example, Aspire has provided a response to a consultation issued by the Mid Essex Clinical Commissioning Group on how it can make savings to its Continuing Healthcare (CHC) budget.  Continuing Healthcare is a free health and social care package provided through the NHS for those with the highest level of need.   The Mid Essex CCG has seen the demands on CHC increase by £8 million in the last year, and believes this growth is unsustainable.   Its preferred solution is that all new applicants for CHC should receive funding for care in their own home only where the cost of this is a maximum of 10% higher than the cost of placing them in a nursing home.

Aspire believes it is wrong to compare the costs of providing care to someone in a nursing home and in their own home in this way.  There is the suggestion that the outcomes in both instances are similar - they are not.   Our research has shown the catastrophic impact being on someone with SCI of being discharged to a nursing home.  Rigid schedules and lack of transport attached make it impossible to work, be involved in community activities, or play an active role in family life.  A lack of specific medical knowledge amongst nursing home staff also means that people with SCI are far more likely to develop physical complications and be re-admitted into hospital for long periods of time.  And, as we have seen with Lawrence, they are also likely to experience severe depression.  

Ironically, therefore, although this cost-cutting measure may save the CCG money in the short term, it may ultimately result in extra costs for the NHS.  Hundreds of expensive bed-days are wasted by avoidable readmissions, for instance.

Yet there is also a deeper question about what the UK – our government and our society -  believes that healthcare funding should achieve.  Yes, the CCG’s plans may lead to people with SCI being able to survive at a lower cost to the NHS.  But nobody who has read the interviews with Lawrence and others in his situation could believe they were leading anything like a full life.  In fact, in our response to the consultation, Aspire has argued that forcing people to live in care homes may actually undermine one of their most basic of rights, their human right to a family life.  Can it be right that the drive to save costs could leave us with a healthcare system that does not even fulfil basic human rights?

The Prime Minister used his first speech after the election to celebrate the NHS, set out his plans for its future, and promised not to make any cuts.  For the disabled people of Mid Essex who rely on CHC funding, this speech may soon come to sound somewhat hollow.  Aspire urges national government and CCGs alike not to view moving someone into a nursing home as viable alternative to providing care in a person’s own home.  Otherwise, more statements like Lawrence’s may start to follow.